| Autor: |
Notsuda H; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University., Oshio H; Department of Thoracic Surgery, Isawa Hospital., Onodera K; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University., Hirama T; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University., Watanabe Y; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University., Watanabe T; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University., Suzuki T; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University., Oishi H; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University., Niikawa H; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University., Saito-Koyama R; Department of Pathology, National Hospital Organization, Sendai Medical Center., Noda M; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University., Tominaga J; Department of Diagnostic Radiology, Tohoku University Hospital., Okada Y; Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University. |
| Abstrakt: |
Recent advancements in computed tomography (CT) scanning have improved the detection rates of peripheral pulmonary nodules, including those with ground-glass opacities (GGOs). This study focuses on part-solid pure ground-glass nodules (GGNs) and aims to identify imaging predictors that can reliably differentiate primary lung cancer from nodules with other diagnoses among part-solid GGNs on high-resolution CT (HRCT). A retrospective study was conducted on 609 patients who underwent surgical treatment or observation for lung nodules. Radiological findings from pre-operative HRCT scans were reviewed and several CT imaging features of part-solid GGNs were examined for their positive predictive value to identify primary lung cancer. The proportions of the nodules with a final diagnosis of primary lung cancer were significantly higher in part-solid GGNs (91.9%) compared with solid nodules (70.3%) or pure GGNs (66.7%). Among CT imaging features of part-solid GGNs that were evaluated, consolidation-to-tumor ratio (CTR) < 0.5 (98.1%), pleural indentation (96.4%), and clear tumor border (96.7%) had high positive predictive value to identify primary lung cancer. When two imaging features were combined, the combination of CTR < 0.5 and a clear tumor border was identified to have 100% positive predictive values with a sensitivity of 40.8%. Thus we conclude that part-solid GGNs with a CTR < 0.5 accompanied by a clear tumor border evaluated by HRCT are very likely to be primary lung cancers with an acceptable sensitivity. Preoperative diagnostic procedures to obtain a pathological diagnosis may potentially be omitted in patients harboring such part-solid GGNs. |
